MEDICARE: BRANJREWC, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1477255453
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRANJREWC, LLC

Provider Business Mailing Address
First Line	:	10130 NORTHLAKE BLVD STE 214-108
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33412-1101
Country	:	US
Telephone Number	:	908-413-1991
Fax Number	:

Provider Business Practice Location Address
First Line	:	9389 OSPREY ISLES BLVD
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33412-1118
Country	:	US
Telephone Number	:	908-413-1991
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ROBERT HYLTON
Credential	:
Telephone Number	:	908-413-1991

Provider Enumeration Date	:	03/21/2023
Last Update Date	:	03/21/2023

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Directions to “BRANJREWC, LLC ” Practice Location

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